Press release

Four in 10 smokers incorrectly think nicotine causes cancer

On No Smoking Day, PHE advises going ‘cold turkey’ is least effective way to quit.


Over 58% of smokers still try to quit without using an aid and going ‘cold turkey’ despite this being the least effective way. A Public Health England (PHE) report highlights that public misunderstanding of the harmfulness of nicotine containing products, such as nicotine replacement therapy (NRT) and e-cigarettes, may be linked to inaccurate and confused perception of the risks of nicotine.

The risks of nicotine use are likely to be very low or negligible. NRT is safe and licenced for use in pregnancy and for people with cardiovascular disease. And there is now wide international consensus that e-cigarettes are far less harmful than smoking. It is the cocktail of deadly chemicals in cigarette smoke, including tar and carbon monoxide, which causes almost all of the harm of smoking.

Four in 10 smokers and ex-smokers incorrectly think that nicotine in cigarettes is the cause of most of the smoking-related cancer. Understanding of the harms of nicotine among the general population is similarly poor. In 2017:

  • only 7.5% thought that none or a very small part of the risk of smoking comes from nicotine
  • 14% thought that it was nearly all the risk
  • almost a quarter (24.2%) of the population didn’t know

The use of quit aids can greatly increase your chances of quitting successfully. Research shows that:

  • using NRT as a quit aid, such as patches and gums, or e-cigarettes makes it one and a half times as likely you’ll succeed
  • your chances of quitting are doubled if using a stop smoking medicine prescribed by a GP, pharmacist or other health professional
  • expert support from a local stop smoking service gives you the best chance of quitting successfully
  • combining quit aids with expert support makes it four times as likely you’ll stop smoking successfully

Professor John Newton, Director of Health Improvement at PHE said:

Misunderstanding about the risks from nicotine may be deterring smokers from using quit aids such as e-cigarettes or nicotine replacement therapies like patches and gums.

Nicotine is addictive but it’s the many thousands of chemicals in tobacco smoke that are responsible for almost all of the harm caused by smoking. Using nicotine quit aids helps manage cravings and can be one of the solutions to helping you stop for good. Going ‘cold turkey’ is not recommended as it’s the least successful way.

To get the most benefit, make sure you use as much nicotine replacement as you need, and for as long as you need, as this will help you stop smoking and stay smokefree. Combining quit aids with support from a stop smoking service gives the best success rates. With the wide range of aids now available, there’s never been a better time to stop.

PHE has been supporting all NHS trusts across the country to do all they can to become truly smokefree. The government and NHS England have both made commitments to a smokefree NHS, in the latest tobacco control plan and the NHS five year forward view.

Professor Newton comments:

For a truly smokefree NHS to become a reality, our emphasis is to support hospitals shift their efforts away from simply ‘enforcing’ no smoking towards offering on-going support to help smokers stop for good, including encouraging them to use quit aids.

Smoking rates are at their lowest ever level (15.5% of the adult population), but there are still nearly 7 million smokers in England. Smoking kills 79,000 people in England every year and for every death another 20 smokers are suffering from a smoking-related disease.


For further information or interview bids contact:

Public Health England press office

NHS Smokefree

Visit the NHS Smokefree site for support and advice on quitting smoking.

PHE’s e-cigarette evidence review

Read the annual update of PHE’s e-cigarette evidence review by leading independent tobacco experts.

Smoking prevalence figures

In 2016, 15.5% of adults aged 18 and over in England currently smoke, down from 19.9% in 2010. In 2000, 26.8% of adults aged 16 and over were smokers. Prevalence since 2010 has fallen most in younger age groups according to Statistics on Smoking, England 2017.

PHE’s Tobacco Control Profiles

For local smoking prevalence figures and additional local data see Local Tobacco Control Profiles.

Costs of smoking

The total cost from smoking to society in England is approximately £14.7 billion a year. This includes the cost to the NHS of treating diseases caused by smoking which is approximately £2.5 billion a year.

Source: ASH: The Local Cost of Tobacco – ASH Ready Reckoner and Towards a Smokefree Generation: A Tobacco Control Plan for England.

Tobacco Control Plan for England

The government’s new Tobacco Control Plan sets a series of challenging ambitions:

  • reduce adult smoking rates from 15.5% to 12% or less
  • reduce the prevalence of 15 year olds who regularly smoke from 8% to 3% or less
  • reduce the prevalence of smoking in pregnancy from 10.7% to 6% or less

Public Health England

Public Health England exists to protect and improve the nation’s health and wellbeing, and reduce health inequalities. We do this through world-leading science, knowledge and intelligence, advocacy, partnerships and providing specialist public health services. We are an executive agency of the Department of Health and Social Care, and a distinct organisation with operational autonomy. We provide government, local government, the NHS, Parliament, industry and the public with evidence-based professional, scientific expertise and support. Follow us on Twitter: @PHE_uk and Facebook:

Published 14 March 2018